DR. JOHN WYCLIFF BEDEAU (NPI# 1487646154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487646154 |
| Entity Type | Individual |
| Full Name | DR. JOHN WYCLIFF BEDEAU |
| Credential | M.D. |
| Practice Address |
9301 Largo Drive West Suite 201 Largo MD 20774-4884 |
| Mailing Address |
9301 Largo Dr West Suite 201 Largo MD 20774-4884 |
| Practice Telephone | 3013508722 |
| Practice Fax Number | 3013508822 |
| Mailing Telephone | 3013508722 |
| Mailing Fax Number | 3013508822 |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2015-11-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
D0030666 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DC | 025110100 | 05 |
| Street Address |
9301 LARGO DRIVE WEST SUITE 201 |
| City | LARGO |
| State | MD |
| Zip Code | 20774-4884 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922637156 | Marie Charlotte Teboutsou Tsodzou | Nurse Practitioner | 9317 Lavall Drive, Upper Marlboro, MD 20774 | 2020-04-08 |
| 1467093443 | Richland Support Services Corp. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11551 Joyceton Drive, Upper Marlboro, MD 20774 | 2019-10-01 |
| 1770134124 | Alan L Kahn | Counselor | 301 Largo Rd., Largo, MD 20774 | 2019-09-26 |
| 1619522034 | Francisca Ifeoma Alintah | Registered Nurse | 511 Dennis Magruder Dr., Upper Marlboro, MD 20774 | 2019-08-02 |
| 1609337146 | Crystal Osuchukwu | Counselor | 1300 Mccormick Dr, Upper Marlboro, MD 20774 | 2019-03-27 |
| 1861968489 | Collaborative Concepts of Maryland | Counselor | 1400 Mercantile Lane, Suite 208, Largo, MD 20774 | 2018-10-22 |
| 1073097622 | Triple Angels Homecare Services, Inc. | In Home Supportive Care | 1210 Dixie Bowie Way, Upper Marlboro, MD 20774 | 2018-09-19 |
| 1922589654 | Optimum Resource Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 711 Harry S. Truman Dr, Unit #105, Largo, MD 20774 | 2018-08-21 |
| 1811475254 | Kolawole Richard Olatunde | Home Health Aide | 11405 Villa Court, Upper Marlboro, MD 20774 | 2018-07-28 |
| 1548747769 | Tiara Williams | Counselor | 15207 Harriet Clotilda Way, Upper Marlboro, MD 20774 | 2018-07-20 |
| Find all providers in zip 20774 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689654725 | Miriam R Thomas | Internal Medicine | 8250 Bryan Dairy Rd Ste 200, Largo, FL 33777-1359 | 2006-01-17 |
| 1063417285 | Largo Endoscopy Center Lp | Internal Medicine | 7300 Bryan Dairy Road, Suite 495, Largo, FL 33777 | 2005-06-15 |
| 1881054161 | Meir Mizrahi | Internal Medicine | 8250 Bryan Dairy Rd Ste 200, Largo, FL 33777-1359 | 2016-03-01 |
| 1790193100 | Bilal Aslam | Internal Medicine | 8250 Bryan Dairy Rd, Largo, FL 33777-1353 | 2014-07-29 |
| 1417233818 | Aj Bidani, M.d. Pa | Internal Medicine | 8787 Bryan Dairy Rd, Ste 310, Largo, FL 33777-1251 | 2011-10-29 |
| 1477729408 | Nirmala Sivaprakasapillai | Internal Medicine | 1301 2nd Ave Sw, Largo, FL 33770-3120 | 2008-04-30 |
| 1811182975 | Suncoast Internal Medicine Consultants | Internal Medicine | 13644 Walsingham Rd, Largo, FL 33774-3532 | 2007-09-12 |
| 1922210582 | Justin R. Nudell | Internal Medicine | 8250 Bryan Dairy Rd, Suite 200, Largo, FL 33777-1353 | 2007-05-04 |
| 1720156730 | Peter Ritka | Internal Medicine | 1221 Mercantile Lane, Largo, MD 20774-5374 | 2006-11-30 |
| 1013096973 | Florida Center for Gastroenterology | Internal Medicine | 8250 Bryan Dairy Rd, Suite 200, Largo, FL 33777-1353 | 2006-11-03 |
| Find all providers in LARGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.